A rare case: Congenital Megalourethra in prune belly syndrome
Published on: 30th January, 2018
OCLC Number/Unique Identifier: 7355941035
Introduction: Prune Belly syndrome is a disease characterized by abdominal muscle defect, bilateral cryptorchidsim and urinary system anomalies (reflux megaureter, hydronephrosis, etc.). Pulmonary, cardiac, and gastrointestinal anomalies may also be present. Management of these rare cases is very important. In this case, the clinical course of a patient with Prune Belly syndrome with megaurethra is presented.
Case: The patient from the first gestation and parturition with birth weight of 2500 g and 38 weeks was hospitalized because of the bilateral hydronephrosis. His physical examination revealed undescended testicles and a large penis. The abdominal muscles were not very atrophic. The size of the kidney was small, bilateral hydroureteronephrosis and wide posterior urethra on the ultrasound. Renal function tests were progressively disturbed and the patient underwent cystourethroscopy for diagnostic purposes in terms of posterior urethral valve. A large diverticulum was found in anterior urethra. Prune Belly Syndrome was thought because the orifices were in appearance of reflux. The vesicostomy was applied. After vesicostomy the renal function tests got better but he was hospitalized due to urosepsis two times. In cystoscopic examination, the diverticulum in the urethra was filled with urine and the drainage was very slow. Phimosis was opened with dorsal slit technique. Cutaneous urethrostomy was proximal to the anterior diverticulum.
Conclusion: Prune Belly syndrome should be considered in patients with megaurethra and postrenal or renal insufficiency although there are no obvious clinical findings. In Prune Belly cases, via a large penis with obstruction signs, anterior urethral diverticulum should be considered.
Silent cerebrovascular disease in hypertensive adults is frequent and age-dependent
Published on: 13th August, 2020
OCLC Number/Unique Identifier: 8677986450
Background: Cerebral small vessel disease and extracranial atherosclerotic carotid disease are manifestations of silent cerebrovascular disease (CVD). Information on these two pathologies in hypertensive population with low cardiovascular risk (CVR) is scarce.
Objective: To explore frequency and characteristics of silent CVD in hypertensive adults and cognitive repercussion of these alterations.
Methods: 39 hypertensive patients (mean age: 53.5 years) were studied. Cerebral magnetic resonance imaging (3T), doppler ultrasound of the carotid artery and neuropsychological studies were obtained.
Results: 79% of patients presented white matter lesions (WML), 18% showed only cerebral atrophy and/or enlarged perivascular spaces, 60% presented hyperplasia of intimal media complex (IMC) and/or atheroma plaques. In women, a significant correlation was observed between IMC thickness and bifrontal index, and WML was greater in patients with carotid plaques. A non-significant decrease in neuropsychological performance was observed in the groups of patients with intra and/or extracerebral injury and a negative correlation with the bifrontal index in men was found.
Conclusion: Frequency of intra and extracerebral silent CVD was high in hypertensive adults with low to moderate CVR. WML and brain atrophy were partially related with carotid lesions. Age significantly influenced the appearance of intra and extracerebral lesions. Cognitive performance did not decrease significantly due to the presence of these lesions.
Risk Factors Associated to Patients with Type 2 Diabetes in Lahore District
Published on: 21st May, 2020
OCLC Number/Unique Identifier: 8605996006
Our research aimed to check the impact of some significant risk variables on diabetes growth and the specific goal of this study was to evaluate the connection of industrial fields with diabetes risk variables. The current research also informs us about the most important risk factor for male and female people with diabetes. A cross-section and convenient sample of 100 people, male and female, without discernment of risk factors and diabetes mellitus (Meta-Analysis on the effect of major risk factors on the diabetic patients form Jinnah Hospital Lahore). The risk factors in the general assessment i.e. lack of exercise, kidney problems, high ranges of tests and residence in industrial areas are found to be significant. Assessment of these factors is helpful in early diagnosis and in prognosis of diabetes.
Antimycolytic agents: fungistatic and fungicide
Published on: 6th May, 2022
Invasive fungal infections are described as a continuous and severe harm to human health and they are associated with at least 1.5 million deaths worldwide each year. Amphotericin B exerts its activity through hydrophobic interactions with cell membrane ergosterol, cause the rupturing or leakage of cell membrane. The antifungal azole medicine group is classified as imidazoles (clotrimazole, ketoconazole, miconazole) and triazoles (fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole) that are named according to the number of nitrogen atoms in the azole ring. Flucytosine is a first-line treatment for the management of cryptococcal meningitis. The most routine adverse effects of fluconazole involve accelerated liver enzymes, gastrointestinal complaints, headache, and skin rash. If antacids, PPIs, H2 blockers administered together with ketoconazole medicines; they will reduce the blood levels of ketoconazole by increasing gastric pH because ketoconazole requires an acidic media for dissolution and systematic absorption. Griseofulvin ruptures mitotic spindle during metaphase by interacting with fungal microtubules-(-), fungal mitosis (metaphase arrest), adequate to block expansion of fungi (drug is static), preventing them from damaging.
Colour keys to emotion in management of children and intellectual distraction using coloured games in dental environment for children
Published on: 20th August, 2019
OCLC Number/Unique Identifier: 8220437574
Aim and objective: Dentistry for children is not difficult but is different from what is practiced for adults. The children reacts to differently to people and places around them. Anxiety is an emotional state that helps normal individual defend themselves against a variety of threats and Dental anxiety refers to patients specific response towards dental suitation-associated stress. so the aim is to evaluate the anxiety related management of the children using intellectual mind game of the individual
Study design: The background of the study is to evaluate and study the effectiveness of anxiety control of children using colour distraction between 5 and 12 yrs of age group as one part and the intellectual distraction of children between the same age group using buchanan facial imaging scale and intellectual coloured game chart
Results and conclusion: lowering of anxiety was noticed in the children obtained the favorite colours in the dental environment and easy distraction can be achieved using intellectual gamings.
Hyperparathyroidism in celiac disease: A case study from UAE
Published on: 7th April, 2020
OCLC Number/Unique Identifier: 9272401475
Celiac disease affects 1% of the world population; however it is under diagnosed in UAE. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentation. Hypocalcaemia is a common finding in celiac disease and could be the only presentation of the disease; however hypercalcemia has been previously reported in patients with celiac disease either due to primary hyperparathyroidism or tertiary hyperparathyroidism due to prolonged hypocalcaemia. A normal calcium level on the other hand in patients with untreated celiac disease who also have primary hyperparathyroidism can be due to interplay of these two conditions and may delay the diagnosis of primary Hyperparathyroidism. We report the very first case from our practice in UAE with untreated celiac disease and normal calcium level at presentation, where a diagnosis of primary hyperparathyroidism was not entertained initially. Patient went on gluten free diet which then caused normalization of intestinal abnormalities and likely calcium absorption manifesting as hypercalcemia on subsequent labs. This led to further work up and finally the diagnosis of Primary hyperparathyroidism due to parathyroid adenoma.
Cardiovascular damage during lupus in black African subjects
Published on: 16th July, 2018
OCLC Number/Unique Identifier: 7795917457
Introduction: Systemic lupus is a disseminated inflammation of the conjunctive tissue. Cardiovascular lesions are the first cause of morbidity and mortality in the course of that disease. These lesions are prevalent in 30 to 62% of cases, depending on whether the diagnostic tool is clinical, echocardiographic, or autopsic. Any part of the heart can be affected, yielding manifestations of pericarditis, endocarditis, coronary heart disease, conduction disorders, and rarely myocarditis.
Objective: Describe cardiac manifestations during the follow up of patients diagnosed with systemic lupus.
Patients and Methods: We conducted a transversal descriptive study over a period of 27 months, in the departments of Internal Medicine, Dermatology, and Cardiology of Yalgado Ouedraogo University Hospital of Ouagadougou. All patients diagnosed with systemic lupus according to the American College of Rheumatology criteria, and having done an EKG, a Holter EKG, or a transthoracic echocardiography, were included in the study. Data were collected from inpatient medical records, outpatient follow up registry and booklets.
Results: Cardiovascular lesions were prevalent in 7 cases (43.75%) out of 16 patients diagnosed with systemic lupus. Mean age of patients was 36 years, with extremes of 23 and 51 years. Only female patients were affected in our study. Cardiac manifestations were mainly benign pericarditis, heart failure, and conduction disorders.
Conclusions: Cardiovascular manifestations are frequent during the course of systemic lupus, and occur after few years of disease progression. Transthoracic echocardiography and EKG remain useful non-invasive explorations for the assessment of cardiovascular lesions, despite minor shortcomings.
Use of Rivaroxaban and Apixaban, Two Non-Vitamin K Antagonist Oral Anticoagulants (NOACs), in Renally Impaired Patients - the limits of our knowledge
Published on: 11th October, 2018
OCLC Number/Unique Identifier: 7893782754
Patients with chronic kidney disease are at increased risk of thromboembolic complications and are therefore often managed with anticoagulation therapy [1]. While these patients are traditionally treated with Vitamin K antagonists (VKAs), the Non-Vitamin K antagonist oral anticoagulants (NOACs), such as rivaroxaban and apixaban are being used with increasing frequency. Relatively new to the anticoagulant treatment arsenal, both compounds are direct Factor Xa inhibitors and represent an alternative to traditional VKA treatments, such as warfarin. However, because these compounds are at least partially renally eliminated, achieving safe and effective anticoagulation in this vulnerable population has proven to be a challenge [2,3]. With limited published data, there is often uncertainty surrounding which of the NOACs can be safely used.
Transcatheter arterial chemoembolization combined with molecular targeted therapy for a patient with hepatocellular carcinoma with intrahepatic metastasis and main portal vein tumor thrombus: A case report and literature review
Published on: 2nd June, 2020
OCLC Number/Unique Identifier: 8616348339
Hepatocellular carcinoma (HCC) is characterized by high morbidity, high recurrence, and high mortality rates. In China, the morbidity of HCC is fifth among all malignant tumors and HCC is the third most common cause of cancer-related deaths. Most HCC patients also have liver cirrhosis. Surgery is the sole curative method for HCC; however, many patients are diagnosed with HCC during its advanced stages so radical resection can no longer be performed. Therefore, the proportion of patients who undergo radical hepatectomy is less than 30%. Patients with mildly advanced HCC cannot undergo hepatectomy and thus transcatheter arterial chemoembolization (TACE) and/or biological targeted therapy are alternative options. However, data on the effects of TACE therapy or biological targeted therapy are limited. Therefore, an investigation of multimodal and individualized treatments is critical to ensure the best treatment. In June 2018, we treated an advanced HCC patient with multiple metastases and right portal vein tumor thrombus. The patient exhibited partial remission after undergoing treatment with TACE and crizotinib capsules for 1 month. The case and a literature review are reported here.
Produce starch-based bioplastic from different renewable biomass sources
Published on: 28th December, 2022
Due to the adverse environmental impacts of synthetic plastics, biodegradable plastics development for both industrial and commercial applications is essential for the present scenario. In addition to the non-degradability of petroleum-based plastic and its impacts, so it is very important to find an alternative to petroleum-based plastic. Starch-based bioplastics are an excessive substitute for petroleum-based plastics due to their significant properties compared with natural sources. This research aims to formalize five new formulas of bioplastic by combining two sources of starch, extracted from various biomass sources, its properties and comparison between them. The moisture content shows 2.07% and 0.984% for samples F and B respectively and that indicates that the samples which contain a high amount of corn starch have less moisture content. The highest results of biodegradation percentages were 68.27% and 52.6% which are for samples A and D respectively, and the lowest biodegradation percentage were 34.33% and 31.29% which are for samples F and B respectively.
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